Functional state of the pancreas and quality of life in patients with chronic pancreatitis in the long-term postoperative period

The purpose of the study was to investigate the functional state of the pancreas and the quality of life in patients with chronic pancreatitis in the long-term postoperative period. Materials and methods. The study was based on the results of examination and surgical treatment of 87 patients with various forms of chronic pancreatitis (16 patients with obstructive CP, 36 – with calcifying CP, and 36 – with inflammatory CP), who underwent 126 surgical interventions (35 resections; 91 drainages) on the pancreas. The assessment of the functional state of the pancreas and the quality of life of patients with chronic pancreatitis before and after surgical treatment was carried out using the following methods: the VAS and Bloechle scales for pain assessment; the SF-36, SF-12, GIQLI, and PANQOLI scales for determining the quality of life; detection of exocrine and endocrine pancreatic insufficiency according to clinical and anthropometric data, the nutritional risk screening NRS-2002, and the levels of glycated hemoglobin, fasting blood glucose, and glucose 2 hours after an oral glucose tolerance test. Results. It has been established that the Bloechle pain assessment scale is a reliable method for studying pain syndrome in all patients with CP, regardless of its form, which allows recording its statistically significant decrease in the postoperative period (p<0.05). The study of the anthropometric data of patients with CP, the clinical manifestations of the disease, and the nutritional risk screening NRS-2002 allows us to adequately assess their trophological status, select enzyme therapy, and follow up in the postoperative period. It has been proven that before surgery, pancreatic exocrine insufficiency is more common in patients with inflammatory and calcifying CP with a predominant lesion of the pancreas head, which increases after resection interventions. The study of glycated hemoglobin and fasting glucose levels provide a reliable assessment of the carbohydrate status of patients with CP. Endocrine dysfunction in the postoperative period occurs in 25% of CP patients, mainly those who have undergone resection surgery. Conclusion. The PANQOLI questionnaire is the most sensitive and specific method for assessing the quality of life in patients with CP: 84.5 points or higher correspond to 100% satisfactory surgical treatment results. The study of the long-term results of surgical treatment in patients with CP, the validity of the chosen surgical intervention option, and the correctness of its technical implementation should be based on the use of effective methods for assessing the functional state of the pancreas and quality of life.